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美国门诊护理环境中抗高血压药物的处方模式。

Prescribing Patterns of Antihypertensive Medications in US Ambulatory Care Settings.

作者信息

Sahakian Yelena, Bylykbashi Brisilda, Rahman Ateequr

机构信息

College of Pharmacy, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.

出版信息

Pharmacy (Basel). 2019 Jun 14;7(2):64. doi: 10.3390/pharmacy7020064.

Abstract

Over 70 million Americans are diagnosed with hypertension. Adherence to current AHA/ACC 2017 hypertension guidelines and appropriate antihypertensive therapy is important for optimal treatment outcomes. This study investigates prescribing patterns for ambulatory care patients with hypertension and adherence to these guidelines. Data from the 2015 National Ambulatory Medical Care Survey (NAMCS) were used in the study. Patients with primary diagnoses of essential hypertension were extracted from the data using ICD-9 code "401". A total of 595 patients were identified. Correlation among demographic variables, source of payment and prescriber specialty were examined. Chi-square and descriptive analysis were performed. 51.4% of the prescriptions were non-first-line medications. Primary care physicians and cardiologists adhered to the guidelines more, when compared to the other specialties. There was a significant difference between various geographic regions, as it relates to guidelines adherence. This study concluded that prescribers do not always adhere to the AHA/ACC 2017 hypertension guidelines. It is recommended to adhere to the guidelines if there are no contraindications. The study's findings were limited to the ambulatory patients visiting providers in 2015 and by the operational definitions of the study.

摘要

超过7000万美国人被诊断患有高血压。遵循当前美国心脏协会/美国心脏病学会2017年高血压指南并进行适当的抗高血压治疗对于实现最佳治疗效果至关重要。本研究调查了门诊高血压患者的处方模式以及对这些指南的遵循情况。该研究使用了2015年国家门诊医疗护理调查(NAMCS)的数据。使用ICD - 9代码“401”从数据中提取原发性高血压的患者。共识别出595名患者。研究了人口统计学变量、支付来源和开处方者专业之间的相关性。进行了卡方检验和描述性分析。51.4%的处方使用的是非一线药物。与其他专科相比,初级保健医生和心脏病专家对指南的遵循程度更高。不同地理区域在指南遵循方面存在显著差异。本研究得出结论,开处方者并不总是遵循美国心脏协会/美国心脏病学会2017年高血压指南。建议在没有禁忌症的情况下遵循这些指南。该研究的结果仅限于2015年就诊的门诊患者以及该研究的操作定义范围。

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